The demographics of physician-scientists have been skewed dramatically over the past decade, with the proportion of NIH-funded principal investigators in their 60s and 70s soaring and younger physician- scientists in marked decline. This shift is particularly noted in procedural disciplines, like pulmonary and critical care medicine, where lucrative clinical practices lure away talented doctors, who in another era would have entered academic medicine. At Stanford University, we seek to reverse this trend by inspiring individuals to enter discovery-based careers through exposure to a new and dynamic vision of science energized by brilliant new technologies emerging here and neighboring Silicon Valley. This new Stanford T32 Training Grant Proposal combines adult and pediatric pulmonary programs in order to select the most promising Trainees and provide an optimally diverse interdisciplinary training experience. Dr. Mark Nicolls, the adult chief and Dr. David Cornfield, the pediatric chief, will share Program Director responsibilities; each bringing unique and complementary skills to the leadership position. We have carefully screened 30 Mentors from the Stanford biomedical community with a strong track record of training and academic productivity. Based on the expertise of our Mentors, we have identified eight domains of excellence from which trainees can choose a primary focus for an individualized development plan. These research areas include: 1) Vascular Disease, 2) Stem Cells & Lung Development, 3) Genetics & Genomics, 4) Lung Injury & Repair, 5) Lung Microbiome, 6) Lung Cancer and 7) Outcomes Research, and 8) Imaging. The grant proposal outlines a process by which pulmonary/critical care fellows at Stanford are exposed to research areas, introduced to Mentors, and move through a selective process designed to identify Trainees with the best chance of success in academic medicine. We describe a well-supported and carefully constructed system of oversight to promote recruitment of underrepresented minorities. All T32 trainees will have an individualized development plan that includes a core curriculum and electives appropriate to their research domain. Through a longitudinal bimonthly T32 meeting lead by the PDs and quarterly informal meetings with T32 trainees, Mentors and PDs, Trainees will be immersed in a micro-culture of academic pulmonary medicine. A Scientific Oversight Committee will identify appropriate coursework and ensure ongoing and timely Trainee progress. We have assembled an experienced Internal Advisory Committee at Stanford and an acclaimed group, with strong Stanford ties, for the External Advisory Committee. We will utilize regular feedback from these groups, the Mentors and Trainees to identify programmatic strengths and weaknesses and reassess our processes to adjust, adapt and improve the T32 fellowship. While acknowledging the inherent challenges of retaining physicians in academic medicine, Stanford is particularly well poised to capture, develop and inspire the next generation of physician-scientists and clinical researchers.